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the County Consult

A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.

Pharm & Cheese: Asymptomatic Hyperglycemia

September 22, 2025

Imagine. You're on a busy red team shift. A clinic calls to send a patient with asymptomatic hyperglycemia to the ED. You roll your eyes, transfer it to the attending. The patient of course lands in the resus bay and you go to evaluate them. Their sugar is 450 mg/dL, they have no symptoms and their vitals are normal.  You mindlessly order a VBG, basic labs and a liter of fluid and move on with your day. However, is this all necessary? What should our end goal be? What should I choose as my intervention if necessary? Do I even need labs?

Kathryn McGregor MD, Joanne Routsolias PharmD, and Eric Leser MD

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In Endocrine, Pharmacology Tags Weekly Cheese
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Pharm & Cheese: ⚡ Thyroid Storm 🌩

September 22, 2025

There are no specific lab value parameters that differentiate thyroid storm from less severe thyrotoxicosis, but the presence of multiorgan dysfunction is key8. We have a great guideline for general thyrotoxicosis management (“Thyrotox Updated Guideline”) on the Intranet, so this Cheese is only a closer look at thyroid storm in particular. 

Nanditha Ravichandran MD, Joanne Routsolias PharmD, and Eric Leser MD

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In Endocrine, Pharmacology Tags Pharmocology, Weekly Cheese
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Pharm & Cheese: Nebulized TXA

August 14, 2025

Bedside Clinical Question: Can nebulized tranexamic acid (TXA) be used as treatment in a patient presenting with hemoptysis?

Yasmeen Ettrick, PharmD PGY1 Pharmacy Resident and Joanne Routsolias, PharmD, RN, BCPS, Clinical PharmD Specialist

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In Pharmacology Tags Pharmocology, PharmD Pearl
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